group_1_chapters_1_3fandomcom-20200214-history
Chapter 3: Person-Environment-Occupation (PEO) Model
PEO aka Canadian Model *conceptual framework developed by Canadian OT clinicians and researchers *provide systematic analysis of complex occupational performance issues within context of OT practice Development of PEO Model *developed in 1990's *built on the work of many environmental-behavioral theorists **'environmental press: '''forces in environment, together with individual needs, evoke a response ***Ex. crowd cheering **influenced by '''Theory of Optimal Experience ' ***'described people engaged in occupations **'"flow"': loosing oneself in inherently satisfying activity **'"nested social systems"' ***'microsystem (center): individual ***mesosystem (surrounds micro.): family and work/school ***exosystem (surrounds meso.): formal and informal social systems ***macrosystem (surrounds exo.): institutions in society (ex. government) *PEO influenced by: **Healthy Communities Conceptual model ***Trainor, Pomercy & Pape, 1893 **rise in environment as treatment modality in OT **publication of Occupational Therapy Guidelines for Client-Centered Practice **occupation reclaimed as central focus **focus on people having autonomy over their environment **government policy making self-help and supportive communities new focus vs. only professional interventions **societal changes of growing consumer market and legislation Description of PEO Model *describes transactive, dynamic relationships that occur when people engage in occupations within given environment over time **provide understanding of both enabllng and disabling effects on environment on people and people on environment **made up of person, occupation and 'environment ' Person *incorporates spirituality, social and cultural experience with observable occupational performance *brings affective (feeling), cognitive and physical components *spirituality is core Environment *context in which occupational performance takes place *encompasses both local (families, neighborhoods) and broader (community, provincial/state, national, international) *classified: cultural, institutional, physical and social Occupation *activities and tasks people engage in while carrying out various roles in multiple locations *3 classifications of purpose: self-care, productivity and leisure *place affective, cognitive and physical demands on individual Occupational Performance *result of dynamic relationship between person, environment and occupation over a lifespan *ability to choose, organize and perform satisfactorily in occupations that: **have meaning **culturally defined **contribute to community **age appropriate Dimension of Time *reflect on how individuals grow and change over lifetime **added time pressures with less environmental support **inadequate skills in beginning **roles, occupations and meaning change **occupations and roles may be discontinued or restored **experience dimension in 3 facets ***past, present and future ***people can think in all three Dimension of Space *location **can engage in occupations in multiple locations **each person has defined space and standards for personal comfort **space can be restricted by illness or age *emotional space **socially constructed **given meaning by oneself and others **meaning of place related to: ***enabling and constraining features of environment ***individual described as different by others PEO: Maximizing Fit *max. fit can optimize occupational performance *used to explain how different PEO relationships influence performance **therapists can reflect on fit and make changes to components that will enable improvement in occupational performance PEO in Mental Health *embodies principles of client-centered practice **grounded in daily realities of clients' lives **PEO considers human growth and development across lifespan, which allows for individualized approach *supports reflective EBP **promotes gathering, reflection and use of clinical reasoning **systematic approach *allows for greater understanding of complexity of human performance and experience **considers influential relationships at micro and macro levels *expands options for intervention **broadens focus and guidance to other potential areas of intervention **considers both micro and macro levels *identifies focused interventions with relevant outcomes **measures all components (person, environment, occupation) in assessment in order to target barrier *frames scope of practice **activities of PEO are occupation-based **able to use in variety of roles and settings *facillitates communication of practice both within and outside OT **easily understood by other professions, consumers and family **can be used with other theories and perspectives *Supports advancement in OT **provides tool to build on current knowledge and move profession forward Analyzing Occupational Performance *look at all components individually and as a whole *analyze different layers of relationships and synthesize understanding to find options to make a better fit *relationships are examined by: #assess each element's influence on occupational performance #assess PEO transactions (PxO, OxE, PxE) #recognize meaning #remove barriers and develop supports for better fit *examine from client's perspective for proper meaning Applying PEO to Occupational Therapy Process *applied throughout entire process: from initial evaluation to intervention #identify a priority occupational performance issue #explore factors that influence PEO #examine relationships among PEO components (PxO, OxE, PxE) *formulate plan **communicate with client to confirm/disconfirm, refine or refocus **formulate intervention with client **reduce barriers and increase supports to improve occupational performance *evaluate intervention plan **role of both the client and therapist **determine if effective Application of PEO Model *applied to numerous settings *tool for systematic analysis *advances discussion about EBP *forms partnerships with other sectors to address needs *applys sociology and geographical concepts concerning meaning of "place" *explores concept of boredom *studies transactional nature of PEO relationships